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Respiratory Care Dec 2015Cardiovascular autonomic neuropathy is one of the factors implicated in the high morbidity and mortality rate in patients with COPD. Thus, several studies and... (Review)
Review
Cardiovascular autonomic neuropathy is one of the factors implicated in the high morbidity and mortality rate in patients with COPD. Thus, several studies and nonsystematic reviews have increasingly reported autonomic function impairment in these subjects. For a better understanding, this systematic review was performed to evaluate not only the evidence for autonomic function impairment, but also factors influencing it. The results of the studies reviewed showed a strong level of evidence to support the impairment of heart rate variability in the time domain. A similar evidence level was also found to support impairment in baroreceptor sensitivity and muscle sympathetic nerve activity. Furthermore, this review identified physical activity level, muscle function, and circadian rhythm as the major influencing factors (strong evidence) of autonomic function in subjects with COPD. However, no definite conclusion could be reached for factors such as dyspnea, anxiety, body composition, pulmonary function, age, breathing frequency, ventilatory effort, quality of life, and disease severity due to limited, conflicting, or lack of existing evidence. The results of this review highlight relevant clinical messages for clinicians and other health-care providers regarding the role autonomic function can play as an important physiological marker for prognostication and stratification. Hence, autonomic function outcomes should be identified and considered during management of patients with COPD. Moreover, this review can serve as basis for future research aimed at assessing the interventions for autonomic function abnormalities in these patients.
Topics: Autonomic Nervous System; Autonomic Nervous System Diseases; Circadian Rhythm; Heart Rate; Humans; Motor Activity; Muscles; Pressoreceptors; Pulmonary Disease, Chronic Obstructive
PubMed: 26487747
DOI: 10.4187/respcare.04174 -
The Journal of Craniofacial Surgery Jul 2015The aim of the article is to elucidate the communications between the trigeminal nerve and facial nerve in the face. In a PubMed search, 328 studies were found using the... (Review)
Review
The aim of the article is to elucidate the communications between the trigeminal nerve and facial nerve in the face. In a PubMed search, 328 studies were found using the terms 'trigeminal nerve, facial nerve, and communication.' The abstracts were read and 39 full-text articles were reviewed. Among them, 11 articles were analyzed. In the studies using dissection, the maxillary branch (V2) had the highest frequency (95.0% ± 8.0%) of communication with the facial nerve, followed by the mandibular branch (V3) (76.7% ± 38.5%). The ophthalmic branch (V1) had the lowest frequency of communication (33.8% ± 19.5%). In a Sihler stain, all of the maxillary branches and mandibular branches had communications with the facial nerve and 85.7% (12/14 hemifaces) of the ophthalmic branches had communications. The frequency of communications between the trigeminal nerve and facial nerve were significantly higher (P = 0.00, t-test) in the studies using a Sihler stain (94.7% ± 1.1%) than the studies using dissection (76.9 ± 35.8). The reason for the significantly higher frequency of trigeminal-facial communication in the studies using a Sihler stain is because of the limitation of the Sihler stain itself. This technique cannot differentiate the motor nerves from sensory nerves at the periphery, and a crossover can be misinterpreted as communication near to nerve terminal.
Topics: Facial Nerve; Humans; Mandibular Nerve; Maxillary Nerve; Motor Neurons; Neural Pathways; Ophthalmic Nerve; Sensory Receptor Cells; Trigeminal Nerve
PubMed: 26114519
DOI: 10.1097/SCS.0000000000001810 -
Current Drug Metabolism 2021Neuropathic pain (NP) is an egregious problem worldwide. Due to the side-effects of oral drugs, drugs delivered directly to the affected area of pain are preferred.
BACKGROUND
Neuropathic pain (NP) is an egregious problem worldwide. Due to the side-effects of oral drugs, drugs delivered directly to the affected area of pain are preferred.
OBJECTIVE
Capsaicin, a chemical compound isolated from chili peppers, is used as an analgesic in topical ointments and dermal patches to alleviate pain. Objective of the study is to review the application and functionality of topical capsaicin in treatment of neuropathic pain.
DATA SOURCES
To systematically review capsaicin's functions on NP, we retrieved articles from the PubMed database published in the last ten years.
STUDY ELIGIBILITY CRITERIA
The inclusion criteria were capsaicin and the use of capsaicin for the treatment of NP; on the other hand, articles were excluded according to the mentioned criteria such as abstracts, articles written in any language other than English, incomplete articles, and conference papers.
PARTICIPANTS AND INTERVENTIONS
Out of 265 articles, 108 articles were selected after filtering through the inclusion and exclusion criteria. The data and knowledge currently existing for capsaicin treatment in NP are summarized.
RESULTS
This review indicates that capsaicin effectively improves NP treatment without affecting the motor and large nerve fibres involved in sensory function. Transient receptor potential channel vanilloid type 1 (TRPV1) is the capsaicin receptor expressed in central and peripheral terminals of a sensitive primary nerve cell. Conclusions and implications of key findings: Topical capsaicin has a sensible safety profile and is effective in reducing NP. Therefore, studies over the last decade suggest that capsaicin might be a potential drug for NP treatment.
Topics: Administration, Cutaneous; Analgesics; Animals; Capsaicin; Disease Models, Animal; Humans; Neuralgia; Sensory Receptor Cells; TRPV Cation Channels; Treatment Outcome
PubMed: 33198614
DOI: 10.2174/1389200221999201116143701 -
Nephrology, Dialysis, Transplantation :... Sep 2018Activation of baroreceptors in the carotid modulates the autonomic nervous system. Baroreflex activation therapy (BAT), which activates baroreceptors in the carotid, has... (Meta-Analysis)
Meta-Analysis
Activation of baroreceptors in the carotid modulates the autonomic nervous system. Baroreflex activation therapy (BAT), which activates baroreceptors in the carotid, has become available in the treatment of resistant hypertension. Besides this, a carotid implant modulating baroreceptors as well as pharmacological modulation of carotid bodies were quite recently presented. This review will underscore currently available and promising approaches that activate baroreceptors in the carotid, and thereby contribute to beneficial effects in patients with arterial hypertension, and discusses potential organoprotective BAT effects beyond blood pressure (BP) reduction. A systematic review and meta-analysis was conducted including observational studies or randomized controlled trials that investigated the effect of BAT on BP in resistant hypertension. Nine studies, seven observational and two randomized, with a total of 444 patients, were included in the evaluation. Analysing the longest follow-up visit from the different studies, there was a significant reduction of systolic BP after BAT of -36 mmHg [95% confidence interval (CI) -42 to -30 mmHg]. Separate meta-analysis of the short-term (1-6 months) and long-term effects (≥12 months) revealed a reduction of -21 mmHg (95% CI -26 to -17 mmHg) and -38 mmHg (95% CI -46 to -30 mmHg), respectively. There are promising data both in the experimental and the clinical application for BAT. Though the present meta-analysis suggests beneficial effects of BAT on BP, the results must be interpreted extremely carefully. Considering that evidence from controlled trials is very limited, it is evident that there is a strong need for further investigation.
Topics: Baroreflex; Blood Pressure; Blood Pressure Determination; Carotid Sinus; Humans; Hypertension; Pressoreceptors
PubMed: 29136223
DOI: 10.1093/ndt/gfx279 -
Ophthalmology Apr 2019OCT is a noninvasive tool to measure specific retinal layers in the eye. The relationship of retinal spectral-domain (SD) OCT measurements with Alzheimer's disease (AD)... (Meta-Analysis)
Meta-Analysis
TOPIC
OCT is a noninvasive tool to measure specific retinal layers in the eye. The relationship of retinal spectral-domain (SD) OCT measurements with Alzheimer's disease (AD) and mild cognitive impairment (MCI) remains unclear. Hence, we conducted a systematic review and meta-analysis to examine the SD OCT measurements in AD and MCI.
CLINICAL RELEVANCE
Current methods of diagnosing early AD are expensive and invasive. Retinal measurements of SD OCT, which are noninvasive, technically simple, and inexpensive, are potential biomarkers of AD.
METHODS
We conducted a literature search in PubMed and Excerpta Medica Database to identify studies published before December 31, 2017, that assessed the associations between AD, MCI, and measurements of SD OCT: ganglion cell-inner plexiform layer (GC-IPL), ganglion cell complex (GCC), macular volume, and choroidal thickness, in addition to retinal nerve fiber layer (RNFL) and macular thickness. We used a random-effects model to examine these relationships. We also conducted meta-regression and assessed heterogeneity, publication bias, and study quality.
RESULTS
We identified 30 eligible studies, involving 1257 AD patients, 305 MCI patients, and 1460 controls, all of which were cross-sectional studies. In terms of the macular structure, AD patients showed significant differences in GC-IPL thickness (standardized mean difference [SMD], -0.46; 95% confidence interval [CI], -0.80 to -0.11; I = 71%), GCC thickness (SMD, -0.84; 95% CI, -1.10 to -0.57; I = 0%), macular volume (SMD, -0.58; 95% CI, -1.03 to -0.14; I = 80%), and macular thickness of all inner and outer sectors (SMD range, -0.52 to -0.74; all P < 0.001) when compared with controls. Peripapillary RNFL thickness (SMD, -0.67; 95% CI, -0.95 to -0.38; I = 89%) and choroidal thickness (SMD range, -0.88 to -1.03; all P < 0.001) also were thinner in AD patients.
CONCLUSIONS
Our results confirmed the associations between retinal measurements of SD OCT and AD, highlighting the potential usefulness of SD OCT measurements as biomarkers of AD.
Topics: Alzheimer Disease; Biomarkers; Cognitive Dysfunction; Cross-Sectional Studies; Humans; Nerve Fibers; Organ Size; Retina; Retinal Diseases; Retinal Ganglion Cells; Tomography, Optical Coherence
PubMed: 30114417
DOI: 10.1016/j.ophtha.2018.08.009 -
Survey of Ophthalmology 2024Although there have been numerous innovations in the management of retinal detachment (RD) over the past decades, there is still limited understanding of the... (Review)
Review
Although there have been numerous innovations in the management of retinal detachment (RD) over the past decades, there is still limited understanding of the pathophysiological processes that take place before and after repair. Summarizing key concepts using animal studies may allow for a better assessment of common pre- and postoperative microstructural abnormalities in RD. We performed a systematic literature review on Ovid MEDLINE, EMBASE, and Cochrane Controlled Register of Trials from January 1968 to January 2022, searching animal or human studies reporting retinal histologic changes following primary or induced RD. Thirty-two studies were included. Main cellular events were summarized: photoceptor apoptosis occurs as early as 12 hours after RD and, although most cells survive, there is extensive remodeling. Outer segments progressively degenerate, while inner segments are reorganized. Rod and cone opsins are redistributed, and rod axons retract while cones undergo changes in shape. Second- and third-order neurons rearrange their dendritic processes, and Müller cells become hypertrophic, growing into the subretinal space. Finally, retinal pigment epithelium cells undergo a change in their morphology. Acknowledging critical morphologic changes following RD is crucial in understanding why anatomical and functional outcomes can vary. Insights from histological studies, together with high-resolution imaging, may be key in identifying novel biomarkers in RD.
Topics: Animals; Humans; Retinal Detachment; Retina; Retinal Cone Photoreceptor Cells; Retinal Degeneration
PubMed: 37652188
DOI: 10.1016/j.survophthal.2023.08.001 -
Current Eye Research Aug 2021The optical coherence tomography (OCT) has been used to evaluate the changes of retinal degeneration in patients with diabetic peripheral neuropathy (DPN) in recent... (Meta-Analysis)
Meta-Analysis
PURPOSE
The optical coherence tomography (OCT) has been used to evaluate the changes of retinal degeneration in patients with diabetic peripheral neuropathy (DPN) in recent years, but the results of previous studies were controversial. Therefore, systematic review and meta-analysis were performed to evaluate the degree of retinal neurodegeneration in DPN measured by OCT.
METHODS
A comprehensive search of PubMed, Embase, Web of Science, Scopus, China Biomedical Literature (CBM), China National Knowledge Infrastructure (CNKI), VIP, and Wanfang databases were performed to identify studies that evaluate retinal neurodegeneration in DPN by using OCT. The included studies were critically reviewed and meta-analyses were performed to evaluate differences of the OCT-derived parameters between the DPN and non-DPN patients.
RESULTS
Twelve studies were included in the final meta-analysis, involving a total of 1,807 eyes (573 in the DPN group and 1,229 in the non-DPN group). The mean peripapillary retinal nerve fiber layer (pRNFL) thickness was significantly lower in the DPN group than in the non-DPN group (weighted mean difference [WMD] = -8.37 μm; 95% CI: -11.00, -5.74). The reduction of pRNFL thickness was the most pronounced in the inferior quadrant, and the differences in the nasal and temporal quadrants were also statistically significant, with WMD (95% CI) being -4.63 μm (-7.51, -1.76) and -3.92 μm (-6.86, -0.98), respectively. Similar results were observed for macular parameters, with WMD and 95% CI being -1.0 μm (-1.5, -0.5) for macular retinal nerve fiber layer (mRNFL), -2.7 μm (-10.7, -5.3) for macular ganglion cell-inner plexiform layer (mGCIPL), and -2.2 μm (-4.4, -0.04) for macular ganglion cell complex (mGCC), respectively.
CONCLUSIONS
Patients with DPN present with significant retinal neurodegeneration, with reduced pRNFL, mRNFL, mGCIPL, and mGCC thickness. Measurements of OCT parameters may serve as a biomarker for diagnosing and monitoring DPN.
Topics: Diabetic Neuropathies; Humans; Nerve Fibers; Retinal Degeneration; Retinal Ganglion Cells; Tomography, Optical Coherence
PubMed: 33428500
DOI: 10.1080/02713683.2021.1874025 -
Chronic Respiratory Disease Aug 2017Patients with chronic obstructive pulmonary disease (COPD) show several extrapulmonary abnormalities such as impairment in the autonomic function (AF). Similarly, the... (Review)
Review
Patients with chronic obstructive pulmonary disease (COPD) show several extrapulmonary abnormalities such as impairment in the autonomic function (AF). Similarly, the use of respiratory training techniques such as controlled breathing techniques, noninvasive mechanical ventilation (NIMV), and oxygen supplementation for AF modulation in patients with COPD is popular in existing literature. However, the evidence to support their use is nonexistent. A systematic search of studies reporting on the effect of controlled breathing techniques, NIMV, and/or oxygen supplementation techniques on AF outcome parameters was conducted in three online databases: PubMed, Embase, and Web of Science. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement, relevant studies were retained and qualitatively analyzed for evidence synthesis. The methodological quality in these studies was evaluated using the evidence based guideline development (EBRO) checklists per designs provided by the Dutch Cochrane Centre. Eighteen studies met the inclusion criteria of the review and were included and discussed. The evidence synthesis revealed that a strong and moderate level evidence supported oxygen supplementation and slow breathing techniques, respectively, in significantly enhancing the baroreceptor sensitivity (BRS) values in patients with COPD. The effect of the examined techniques on the heart rate variability and muscle sympathetic nerve activity was of a limited or inconsistent evidence. The findings from this review suggest that oxygen supplementation and controlled breathing techniques have profound positive influence on the BRS in patients with COPD. However, it is not fully clear whether these influence translates to any therapeutic benefit on the general AF of patients with COPD in the long term.
Topics: Breathing Exercises; Heart Rate; Humans; Noninvasive Ventilation; Oxygen Inhalation Therapy; Pressoreceptors; Pulmonary Disease, Chronic Obstructive; Sympathetic Nervous System
PubMed: 28774205
DOI: 10.1177/1479972316680844 -
Sensors (Basel, Switzerland) Feb 2023This systematic review documents the protocol characteristics of studies that used neuromuscular electrical stimulation protocols (NMES) on the plantar flexors [through...
This systematic review documents the protocol characteristics of studies that used neuromuscular electrical stimulation protocols (NMES) on the plantar flexors [through triceps surae (TS) or tibial nerve (TN) stimulation] to stimulate afferent pathways. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement, was registered to PROSPERO (ID: CRD42022345194) and was funded by the Greek General Secretariat for Research and Technology (ERA-NET NEURON JTC 2020). Included were original research articles on healthy adults, with NMES interventions applied on TN or TS or both. Four databases (Cochrane Library, PubMed, Scopus, and Web of Science) were systematically searched, in addition to a manual search using the citations of included studies. Quality assessment was conducted on 32 eligible studies by estimating the risk of bias with the checklist of the Effective Public Health Practice Project Quality Assessment Tool. Eighty-seven protocols were analyzed, with descriptive statistics. Compared to TS, TN stimulation has been reported in a wider range of frequencies (5-100, vs. 20-200 Hz) and normalization methods for the contraction intensity. The pulse duration ranged from 0.2 to 1 ms for both TS and TN protocols. It is concluded that with increasing popularity of NMES protocols in intervention and rehabilitation, future studies may use a wider range of stimulation attributes, to stimulate motor neurons via afferent pathways, but, on the other hand, additional studies may explore new protocols, targeting for more optimal effectiveness. Furthermore, future studies should consider methodological issues, such as stimulation efficacy (e.g., positioning over the motor point) and reporting of level of discomfort during the application of NMES protocols to reduce the inherent variability of the results.
Topics: Adult; Animals; Humans; Afferent Pathways; Checklist; Electric Stimulation; Fishes; Leg; Tibial Nerve
PubMed: 36850945
DOI: 10.3390/s23042347 -
Current Eye Research May 2017Many studies have assessed the changes of retinal nerve fiber layer (RNFL) thickness in patients with obstructive sleep apnea syndrome (OSAS), but the results were... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Many studies have assessed the changes of retinal nerve fiber layer (RNFL) thickness in patients with obstructive sleep apnea syndrome (OSAS), but the results were inconsistent. Therefore, a meta-analysis was performed to evaluate the RNFL changes in OSAS measured in vivo.
METHODS
Pertinent studies were identified by a comprehensive search of PubMed, Embase, Web of science, Cochrane library, Scopus, and Chinese biomedical disc databases from inception to August 2016. A fixed effects model was used to pool the weighted mean difference (WMD) and 95% confidence interval (CI) between OSAS group and control group.
RESULTS
Seventeen studies were included in the final analysis, with 12 for descriptive analysis and 5 for meta-analysis, involving a total of 1757 eyes (1106 in the OSAS group and 651 in the control group). The RNFL in OSAS was significantly lower than control group, with pooled WMD -3.53 (95%CI: -4.80 to -2.26, P < 0.001) for average RNFL, -3.69 (95%CI:-5.49 to -1.89 P < 0.001) for superior RNFL, -4.66 (95%CI: -6.92 to -2.39, P < 0.001) for inferior RNFL, -3.15 (95%CI:-5.19 to -1.10, P = 0.003) for nasal RNFL, and -2.45 (95%CI: -4.59 to -0.31, P = 0.025) for temporal RNFL. Along with severities of OSAS, a trend of more profound reduction of average RNFL was observed in advanced OSAS, with WMD of average RNFL thickness -1.75 (95%CI:-4.47 to -0.98, P = 0.209) for mild OSAS, -3.54 (95%CI:-6.33 to -0.73, P = 0.013) for moderate OSAS, and -7.17 (95%CI:-10.00 to -4.34, P < 0.001) for severe OSAS. The majority of studies in the descriptive review demonstrated similar findings.
CONCLUSION
The OSAS was associated with a reduced RNFL in all quadrants compared to controls. Evaluation of RNFL may serve as a tool for grading severities of OSAS. Considering the limited evidence, the conclusions should be interpreted cautiously.
Topics: Disease Progression; Humans; Nerve Fibers; Retinal Diseases; Retinal Ganglion Cells; Sleep Apnea, Obstructive; Tomography, Optical Coherence
PubMed: 27854132
DOI: 10.1080/02713683.2016.1238942